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Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar)

Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar). Dr. Phyu Phyu Swe Health Services Manager (TB) Population Services International/Myanmar 25 July 2012. Presentation outline. TB & HIV situation in Myanmar

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Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar)

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  1. Integrated TB-HIV Services at PSI Clinical Social Franchise Network(Myanmar) Dr. Phyu Phyu Swe Health Services Manager (TB) Population Services International/Myanmar 25 July 2012

  2. Presentation outline • TB & HIV situation in Myanmar • National strategic plan for TB-HIV services integration • PSI/Myanmar health service system • Integration of TB-HIV service at PSI franchised network • Achievement • Challenges/Lessons learnt • Future plan

  3. INDIA KACHIN BANGLA DESH CHINA SAGAING SHAN CHIN MANDALAY RAKHINE MAGWE LAOS KAYAH BAGO KAYIN AYARWADDY YANGON THAILAND MON TANINTHARYI TB & HIV Situation in Myanmar One of the 41 high TB-HIV burden countries HIV prevalence among TB patients (2010) 10.4% TB prevalence among PLHA (2010) 30-40% Global TB control, 2011 , HSS 2010

  4. National strategic plan for TB-HIV services integration (2012-2015) • Goal: • To reduce the burden of HIV-related TB to achieve the 2015 MDG target Plan to scale up to all townships & public hospitals by 2015

  5. PSI/M Health Services System Two tiered social franchise network Case management Health talk Referrer Primary care SQH: Sun Quality Health SPH: Sun Primary Health

  6. Sun Quality Health Social Franchise model Affordable services to Health impact Healthy behavior Technical support Product IECs Franchiser Franchisee Consumer Monitoring & Supervision Fractional franchise system

  7. Integrated Approach…… PPM-DOTS ART PICT 2001 2008 2009 2010 2003 2004 2007 STIs RH Pneumonia U5 children Malaria

  8. Achievement of PPM-DOTS program 12.1% 7.6% 11.5% 8% NTP + PSI 7.6% NTP only 5.1% 2.3% MIS data

  9. TB-HIV Integration • Referral voucher to PSI/VCT • CPT • ART PPM-DOTS PICT 2001 2008 2009 2010 2003 2004 2007 STIs Pneumonia U5 children RH Malaria

  10. Provider Initiated HIV Counseling & Testing (2010) PICT Start voucher system HIV prevalence among TB patients – 9% MIS data

  11. Achievement of TB-HIV Integrated Service (21%) (11%) (8%) (26%) As of April (1%) 143 out of 862 SQH clinics provide PICT MIS data

  12. One Stop Service For TB-HIV ART DOTS CPT PICT 7 SQH clinics + 2 PSI/VCT 50 PLHA 143 SQH clinics 862 SQH clinics

  13. Challenges “No ART if we found positive client” (SQHC) “We are busy we can’t afford time” (SQHC) “I dare not face the positive result” ” I don’t need the test” (Client) PSI’s qualitative research on PICT service May 2012 Double stigma Time consuming ART inavailability Data burden Client awareness on TB-HIV co-infection Funding for sustainability & expansion

  14. Future Plan Expand PICT to cover 80% of TB registered cases at Sun clinics access the HCT service by 2015 Continue CPT for TB-HIV co-infected patients Integrate ART program to PICT clinics Strengthen ACSM activities Strengthen referral network Sustain collaboration with NTP, NAP and other partners

  15. Thanks

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